Tendencies in disability of the population as a result of malignant neoplasms in Ukraine (on the example of the Poltavia region).

OBJECTIVE: Aim: To study the dynamics of the prevalence and structure of primary disability, including due to cancer, among the population of the Poltava region. PATIENTS AND METHODS: Materials and Methods: The study used a retrospective analysis - the depth of the research search was six years (2019-2023); a comparative analysis - to establish the differences in disability indicators. Determining the trends of disability: analyzing the dynamic series. RESULTS: Results: The rate of initial disability due to neoplasms (including malignant) for 2019-2023 in Ukraine population is generally stable with a slight downward trend, in the Poltava region, there is a slight downward trend during the years 2019-2021, starting from 2022, begins to increase sharply, while throughout Ukraine the indicator remains stable. Among the able-bodied population of the Poltava region: if until 2021 the picture is identical to the indicators among the adult population, then starting from 2022 the disability of this contingent in the Poltava region begins to increase, while in Ukraine - to decrease. In 2023 among the population of the Poltava region, diseases of the musculoskeletal system became the cause of disability in 20.5 per 10,000 working-age population (І rank place) ; from circulatory system diseases was 12.3 (ІІ rank place); the rate of disability from a neoplasm is 16.1(ІІІ rank place). CONCLUSION: Conclusions: Analysis of the dynamics and structure of disabling pathology is important and necessary, as it allows to identify diseases that lead to permanent disability, as well as to develop medical and social measures to prevent disability.

STATE OF ORGANIZATION OF PROVIDING ONCOLOGICAL MEDICAL CARE TO THE POPULATION OF UKRAINE.

OBJECTIVE: Aim: The purpose of this work is to study the state of organizational factors in the provision of oncology care to the population of Ukraine and to determine the needs of the population in oncology care. PATIENTS AND METHODS: Materials and Methods: The following materials were used in study: a report on diseases of malignant neoplasms; report on medical personnel; report on contingents of patients with malignant neoplasms. The used methods were: bibliosemantic, content analysis, analytical, statistical and graphical methods. CONCLUSION: Conclusions: The oncological control system in Ukraine is represented by institutions of various levels. The number of specialized beds is increasing from 8,587 in 2015 to 9,088 in 2021. there is a tendency to decrease the total number of medical personnel by 12% and the number of general practitioners - family medicine by 1.5%. During the period from 2015 to 2021, the contingent of patients with neoplasms increased by 21-24%. The rate of neglect of cases of malignant neoplasms registered in Ukraine during 2022 was 22.4%, which is 1.4% more than in 2021. The system of oncology medical care of Ukraine is at a sufficient level, but there are certain difficulties caused by certain difficulties of the primary health care sector due to the decrease in the number of medical specialists. In the modern context, there are difficulties caused by the difficult migration situation of the population against the background of Russia's military aggression against Ukraine.

THE ROLE OF ADVERSE CHILDREN'S EXPERIENCE IN THE DEVELOPMENT OF PSYCHOLOGICAL DISORDERS AMONG PARTICIPANTS IN ANTI-TERRORISM OPERATION.

OBJECTIVE: The aim: The sense of our research was to examine the reason for the consequential links between negative childhood experiences and the mental state of participants of anti-terrorist operations. PATIENTS AND METHODS: Materials and methods: A standard "Adverse Childhood Experiences (ACEs)" questionnaire was used to obtain primary data. Conflict tactics scales were used to determine emotional, physical, and domestic violence in respondents. RESULTS: Results: The study evaluated 7 categories of ACEs: physical indifference (lack of care and protection); emotional neglect (lack of love); physical violence (pushing, grabbing or slapping); emotional violence (scolded, insulted or suppressed); sexual violence; domestic violence and a family history of mental disorders, diseases or alcohol abuse. All respondents were divided into two groups: those who had psychological disorders and those who were healthy. CONCLUSION: Conclusions: The data obtained in the study indicate that the chances of having psychological disorders increase in those fighters who complained of emotional violence - the feeling of humiliation; physical violence - those who were beaten in childhood; domestic violence was manifested in the fact that the mother was beaten; disadvantaged families where a family member has used drugs or abused alcohol; the presence of depression in parents.

Аnalysis of morbidity and disability among children in the city of Poltava.

OBJECTIVE: The aim: analyze the morbidity and causes of disability among children of Poltava. PATIENTS AND METHODS: Materials and methods: medical and statistical - for the collection, processing and analysis of data (descriptive and analytical statistics to determine relative indicators, absolute growth indicators), a systems approach and system analysis. The work uses materials from the State Statistics Service of Ukraine, as well as data from children's hospitals of Poltava. RESULTS: Review: In recent decades, the morbidity and prevalence of diseases of children`s of Ukraine remained as high. In the Poltava region, the basis of medical work on the sector includes the principles of early access to medical care, early diagnosis, timely examination and adequate treatment. Оver the past five years, there is a decrease in the number of newborns who visited outpatient hospitals. In the structure of causes of childhood disability over the past 5 years, the first three places are occupied by congenital malformations, diseases of the nervous system and diseases of the endocrine system. Moreover, children's disability from diseases of the nervous and endocrine systems is constantly growing. CONCLUSION: Conclusions: One way to improve the health care system for children is to optimize it. It is aimed at improving preventive work, preserving and restoring the health of the child population, improving and updating medical institutions, and increasing the level of professionalism of medical workers.

Analysis of the mortality rate among the population of the poltava region and the ways of its reduction.

OBJECTIVE: Introduction: Saving and improvement of population' health is one of the main priorities of the policy in any country. Studying of the level and causes of mortality is a powerful tool for assessing the effectiveness of health care systems. WHO recommends using of the European classification of preventable causes of death that based on three levels of prevention. PATIENTS AND METHODS: The aim of this study is to compare the level and structure of mortality of the population of Ukraine and the Poltava region, to substantiate scientific approaches to the study and identification of those causes of death that can be prevented in order to formulate prevention programs at different level. Materials and methods: In research are used the information from the State Statistics Service of Ukraine and from the Center for Medical Statistics of the MoH of Ukraine. RESULTS: Review: Despite the positive dynamics of mortality in recent years, both in the Poltava region and in Ukraine, the indicators remain extremely negative. About 73.3% of all fatalities in Ukraine are three main types of causes cardiovascular diseases, external causes of death and neoplasms. In the Poltava region, 70.56% of all causes of death are due to cardiovascular disease; neoplasms occupy 13.88%; external causes - 4.87%; diseases of the digestive system - 3,06%; respiratory diseases - 1.31% of the causes of death. CONCLUSION: Conclusions: The mortality rate both in the Poltava region and in Ukraine has tendency for declines, but remains rather high. General trends in the structure of causes of death: in the first place are diseases of the cardiovascular system, the second - neoplasms, the third -external causes. Structuring of the causes of death that based on the principle of prevention in Ukraine do not conduct.

Epidemiology of diseases of the circulatory system among the population of Poltava region.

OBJECTIVE: Introduction: In Ukraine more than half of deaths have been caused by cardio-vascular diseases (CVD). Among the able-bodied population, the share of CVD in the structure of causes of mortality is 29,9%. In the structure of causes of mortality among the persons of retirement age, CVDs accounted for 75,9% and exceeded the proportion of neoplasms in 6,5 times. The aim is to analyze of morbidity and mortality rates of diseases of the CVD among the population of Ukraine and Poltava region, to conduct a comparative analysis of data to identify possible ways to improve the situation. PATIENTS AND METHODS: Materials and methods: A retrospective study of morbidity and mortality rates by age, gender and cause (2014-2018) was conducted and the statistical method was used to analyze dynamic (time) series. RESULTS: Review: An analysis of the dynamics of population mortality indicates significant fluctuations in it`s levels over ten years. At the same time, by the method of alignment of the dynamic series, a tendency to a slight decrease in the mortality rate of the population from 17,1‰ to 16,9 ‰ was established. The mortality of the population of Ukraine in 2018 from diseases of the circulatory system was 1000,8 per 100 thousand people. Data on mortality rate in the Poltava region significantly higher than those in Ukraine. CONCLUSION: Conclusions: The age structure of the population of Poltava region belongs to the regressive type. The mortality rate among the population of Poltava region is slightly decreasing but remains at a very high level (16,9 ‰). In the structure of causes of death, diseases of the circulatory system are at the first place (70,8%), the second place belongs to neoplasm (13,5%), and third are the external causes of death (4,8%).

Planning of effective evaluation of the activities of hospital district at the example of poltava region.

OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region. PATIENTS AND METHODS: Materials and methods: In this work a set of methods is used: system approach, bibliosemantic, legal, logical modeling. RESULTS: Review: A managerial tool capable of tracking the process and demonstrating the impact of projects, programs and development policies is monitoring and evaluation. The basis of evaluation is the creation of different indicators and indexes. The system of these indicators provides an opportunity to assess the social, medical, economic and environmental aspects of development of hospital district. The monitoring and evaluation program should include monitoring of implementation (contributions and activities) and monitoring of the results of work of the hospital districts (short-term and long-term). CONCLUSION: Conclusions: Hospital districts are created with the aim of optimizing of the organization and functioning of the network of health facilities. The Management Board's decision should be based on valid, reliable information on the development of the hospital district. Compliance with the monitoring and evaluation methodology makes it possible to provide the health care system with qualitative and timely data at all stages of its reformation.

[The main directions of reforming the service of medical statistics in Ukraine].

OBJECTIVE: Introduction: Implementation of new methods of information support of managerial decision-making should ensure of the effective health system reform and create conditions for improving the quality of operational management, reasonable planning of medical care and increasing the efficiency of the use of system resources. Reforming of Medical Statistics Service of Ukraine should be considered only in the context of the reform of the entire health system. The aim: This work is an analysis of the current situation and justification of the main directions of reforming of Medical Statistics Service of Ukraine. PATIENTS AND METHODS: Material and methods: In the work is used a range of methods: content analysis, bibliosemantic, systematic approach. The information base of the research became: WHO strategic and program documents, data of the Medical Statistics Center of the Ministry of Health of Ukraine. RESULTS: Review: The Medical Statistics Service of Ukraine has a completed and effective structure, headed by the State Institution "Medical Statistics Center of the Ministry of Health of Ukraine." This institution reports on behalf of the Ministry of Health of Ukraine to the State Statistical Service of Ukraine, the WHO European Office and other international organizations. An analysis of the current situation showed that to achieve this goal it is necessary: to improve the system of statistical indicators for an adequate assessment of the performance of health institutions, including in the economic aspect; creation of a developed medical and statistical base of administrative territories; change of existing technologies for the formation of information resources; strengthening the material-technical base of the structural units of Medical Statistics Service; improvement of the system of training and retraining of personnel for the service of medical statistics; development of international cooperation in the field of methodology and practice of medical statistics, implementation of internationally accepted methods for collecting, processing, analyzing and disseminating medical and statistical information; the creation of a medical and statistical service that adapted to the specifics of market relations in health care, flexible and sensitive to changes in international methodologies and standards. CONCLUSION: Conclusions: The data of medical statistics are the basis for taking managerial decisions by managers at all levels of health care. Reform of Medical Statistics Service of Ukraine should be considered only in the context of the reform of the entire health system. The main directions of the reform of the medical statistics service in Ukraine are: the introduction of information technologies, the improvement of the training of personnel for the service, the improvement of material and technical equipment, the maximum reuse of the data obtained, which provides for the unification of primary data and a system of indicators. The most difficult area is the formation of information funds and the introduction of modern information technologies.